Cytomegalovirus retinitis: amanifestation of theacquired immunedeficiency syndrome (AIDS)*

SUMMARY Twohomosexual maleswiththe'gaybowelsyndrome' experienced an acuteunilateral lossofvision. Bothpatients hadwhiteintraretinal lesions, whichbecameconfluent. Oneofthe caseshada depressed cell-mediated immunity; bothpatients ultimately diedafter a prolonged illness. Inone patient cytomegalovirus was cultured froma vitreous biopsy. Autopsyrevealed disseminated cytomegalovirus inbothpatients. Widespread retinal necrosis was evident, with typical nuclear andcytoplasmic inclusions ofcytomegalovirus. Electron microscopy showedherpes virus, whileimmunoperoxidase techniques showedcytomegalovirus. Thealtered cell-mediated responsepresent inhomosexual patients may beresponsible fortheclinical syndromes ofKaposi's sarcomaandopportunistic infection byPneumocystis carinii, herpes simplex, orcytomegalovirus.